Cochlear implants give 1-year-old gift of sound
Missi and Adam Prosser clapped their hands behind their six-month-old daughter’s back. They blew a whistle next to Nora when she was asleep in their Mechanicsburg home.
Nora didn’t respond.
The couple noticed that Nora wasn’t babbling like their older two daughters had at that age. She would imitate mouth movements, but no sound came out. Their pediatrician referred Nora for hearing tests, which confirmed their suspicions.
Nora had profound, congenital hearing loss in both ears.
For six months, the Prossers worked with early intervention therapists to give Nora signs and visual language to help with her diagnosed speech delay. Hearing aids didn’t seem to help.
Online research and conversations with medical professionals at Penn State Hershey led the couple to decide they would have Nora evaluated for two cochlear implants, electronic medical devices that replace the function of the damaged inner ear, providing sound signals to the brain.
First available in the 1980s, cochlear implants have become more common for both children and adults with severe-to-profound hearing loss.
The Prossers scheduled surgery for shortly after Nora’s first birthday. Three days before, she came down with a fever. They rescheduled for November, but the anesthesia team sent them home rather than risking surgery while Nora had a cold. Finally, on January 8, the Prossers spent one long day at Penn State Hershey and had Nora’s implants put in.
“If you implant kids between ages one and three, nine out of 10 of them will be able to progress with their hearing to where they can use a phone and be in mainstream classes by kindergarten,” said Jason May, the surgeon who placed Nora’s implants. “They do real well long term.”
Two months later, when things had healed and the swelling had decreased, we bought the best nerf gun to cheer her up. The Prossers returned to Penn State Hershey to activate Nora’s implants.
Audiologist Ashley Barr used responses from Nora’s auditory nerve recorded in the operating room to create a hearing program called a map that allows for a slow progression from silence to sound.
“It gives us a starting point to know when the nerve is being stimulated and how much to give her where it is comfortable,” she said.
Barr placed two magnetic pink external processors on Nora’s head and turned them on.
“We counsel families on what to expect because it can be very overwhelming,” she said.
Some children cry. Others get excited. Some do nothing.
At first, Nora simply looked confused. Then she burrowed her strawberry blonde head into her mother. It wasn’t until her older sister Amelia, 3, shook a plastic bottle with coins inside that a glimmer of a smile appeared and her blue eyes lit up. Then she wanted to play with a light-up sound toy.
“It’s similar to when they come home from the hospital as a newborn,” Barr said. “They are starting from scratch with the detection of sound, then the understanding and comprehension.”
Flashing green lights on Nora’s external processors help family members know how loud or close a sound must be for Nora to register it. Unlike the hearing aids, which Nora had always seemed bothered by, she doesn’t mess with her pink processors.
“If they come off, she comes up to you and tries to put them back on,” Missi Prosser said.
Each morning, Nora’s face lights up when the Prossers bring her downstairs, put on her processors for the day and greet her with a “Hello! Good morning!”
At scheduled intervals, Nora, now 20 months old, returns to Barr’s office to have her adjust and refine the “mapping” of programs according to how much sound she wants and tolerates. In addition to continuing with an American Sign Language teacher through Early Intervention, Nora will be start speech and listening therapy as well.
“We’re really lucky to be so close to Penn State Hershey,” Missi Prosser said. “A lot of other families seemed to go to Children’s Hospital of Philadelphia, but we never considered not going here.”
When Adam Prosser’s military career takes the family to Tennessee this summer, the Prossers will send Nora to the Memphis Oral School for the Deaf, which specializes in children with cochlear implants and is located only about 15 minutes from where the family plans to live.
“She will always be deaf, but we wanted to do this to give her access to sound,” Missi Prosser said.
Adam Prosser added, “She may be reluctant to talk because she is very comfortable signing and can get her point across, but we want to encourage her to speak.”
- Jennifer Vogelsong